Abstract:
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Introduction: Ethiopia is one of 20 countries with a high burden (who share 84% of global
incidence) of TB and TB/HIV for 2015-2020. Universal test and treat modality is
implemented since 2017 that is expected to reduce mortality due to opportunistic infections.
Therefore, determining the current incidence of tuberculosis and identifying its predictors
accordingly is crucial for programming and designing evidence-based decision making. The
study aimed to assess incidence and predictors of tuberculosis infection among adult patients
on HIV care in Public health facilities in Gamo zone, from January, 2017- March, 2020 GC.
Method: Health facility-based retrospective follow up study was conducted among randomly
selected 393 newly enrolled adults to antiretroviral service at public health facilities in Gamo
zone from January, 2017 to March, 2020. Data was collected using a structured data
extraction tool, entered into Epi-data version 4.2.2.1 and exported to Stata version 14 for
analysis. The incidence rate of tuberculosis was calculated. Kaplan-Meier curve and Log-
rank test was used to describe and to compare time-to-event across the different categories.
Cox proportional hazards model fitted and in the multivariable analysis, Adjusted Hazard
Ratio with 95% CI computed, and association with P < 0.05 considered Significant.
Result: Cumulative incidence of tuberculosis was 66 per thousand adults in HIV care and the
overall incidence density of TB was 4.51 per 100 person-year of observation. Baseline CD4
200cells/µl or less, adjusted hazard ratio (AHR: 2.91, 95% CI: 1.21, 6.99), body mass index
(BMI) <18.5 kg/m2
(AHR: 2.93, 95 % CI: 1.28, 6.72), and not taking 6 month full course
isoniazid preventive therapy (AHR: 9.52, 95 % CI: 3.87, 23.40), were significant predictors
for the incidence of TB.
Conclusion and recommendation: The overall incidence rate of TB among adult patients
on HIV care in this study was 4.51 per 100 person years of observation. The predictors for
TB incidence in adult patients on HAART were Underweight status (BMI <18.5 kg/m2
),
baseline CD4 level below 200cells/µl, and not taking full dose isoniazide preventive therapy
for 6 months. Special follow up care should be given to those patients with lower CD4 count
and underweight. Assuring that all candidate clients were getting Isoniazide preventive
